Sugino Kiminori, Ito Koichi, Mimura Takashi, Nagahama Mitsuji, Fukunari Nobuhiro, Kubo Atsushi, Iwasaki Hiroyuki, Ito Kunihiko
Surgical Division, Ito Hospital, The Department of Radiology, Keio University School of Medicine, Tokyo, Japan.
Surgery. 2002 Mar;131(3):245-8. doi: 10.1067/msy.2002.119936.
Anaplastic thyroid carcinoma is a rare and highly lethal neoplasm. We investigated whether operations have an impact on the survival of patients who have anaplastic carcinoma without distant metastasis.
Between 1989 and 1999, 40 consecutive patients with anaplastic carcinoma, without distant metastasis at the time of presentation or during local treatment, were reviewed. The cumulative survival rates and 1-year survival rates were compared.
Eleven patients had a small focus of anaplastic carcinoma in a differentiated carcinoma, and 29 patients had ordinary anaplastic thyroid carcinoma. Surgical debulking was performed in 26 patients. Radiotherapy was used for 31 patients and chemotherapy for 19 patients. The 1-year survival rates of the patients with incidental anaplastic carcinoma, ordinary anaplastic carcinoma who underwent operations, and ordinary anaplastic carcinoma who did not undergo operations were 73%, 60%, and 21%, respectively. A significantly higher cumulative survival rate was observed in patients with incidental anaplastic carcinoma than in those with ordinary anaplastic carcinoma. A significantly better outcome was obtained by surgical debulking of ordinary anaplastic carcinoma.
Patients with incidental anaplastic carcinoma tended to have a good outcome, but some had a poor prognosis. Surgical debulking improved the outcome of patients with ordinary anaplastic carcinoma.
间变性甲状腺癌是一种罕见且致死率很高的肿瘤。我们研究了手术对无间远处转移的间变性甲状腺癌患者生存率的影响。
回顾了1989年至1999年间连续收治的40例间变性甲状腺癌患者，这些患者在就诊时或局部治疗期间均无间远处转移。比较了累积生存率和1年生存率。
11例患者在分化型甲状腺癌中存在小灶间变性癌，29例患者为普通间变性甲状腺癌。26例患者接受了减瘤手术。31例患者接受了放疗，19例患者接受了化疗。偶然发现的间变性癌患者、接受手术的普通间变性癌患者和未接受手术的普通间变性癌患者的1年生存率分别为73%、60%和21%。偶然发现的间变性癌患者的累积生存率显著高于普通间变性癌患者。普通间变性癌患者通过减瘤手术获得了显著更好的预后。
偶然发现的间变性癌患者预后往往较好，但部分患者预后较差。减瘤手术改善了普通间变性癌患者的预后。
